Development and validation of a predictive algorithm to identify adult asthmatics from medical services and pharmacy claims databases

Health Serv Res. 2011 Jun;46(3):939-63. doi: 10.1111/j.1475-6773.2010.01235.x. Epub 2011 Jan 28.

Abstract

Objective: To develop and validate the accuracy of a predictive model to identify adult asthmatics from administrative health care databases.

Study setting: An existing electronic medical record project in Montreal, Quebec.

Study design: One thousand four hundred and thirty-one patients with confirmed asthma status were identified from primary care physician's electronic medical record.

Data collection/extraction methods: Therapeutic indication of asthma in an electronic prescription and/or confirmed asthma from an automated problem list were used as the gold standard. Five groups of asthma-specific markers were identified from administrative health care databases to estimate the probability of the presence of asthma. Cross-validation evaluated the diagnostic ability of each predictive model using 50 percent of sample.

Principal findings: The best performance in discriminating between the patients with asthma and those without it included indicators from medical service and prescription claims databases. The best-fitting algorithm had a sensitivity of 70 percent, a specificity of 94 percent, and positive predictive value of 65 percent. The prescriptions claims-specific algorithm demonstrated a nearly equal performance to the model with medical services and prescription claims combined.

Conclusions: Our algorithm using asthma-specific markers from administrative claims databases provided moderate sensitivity and high specificity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Algorithms*
  • Asthma / epidemiology
  • Asthma / prevention & control*
  • Drug Prescriptions / statistics & numerical data
  • Female
  • Health Status Indicators
  • Humans
  • Insurance Claim Review / statistics & numerical data*
  • Logistic Models
  • Male
  • Management Information Systems / statistics & numerical data*
  • Mass Screening / methods*
  • Middle Aged
  • Multivariate Analysis
  • Quebec / epidemiology
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index